卵巢妊娠9例临床分析

目的 分析9例卵巢妊娠的临床特点.方法 采用回顾性分析方法对卵巢妊娠的发生因素及临床特点进行分析.结果 卵巢妊娠占妊娠总数的0.62%,临床特征为腹痛明显,有的无明显停经史.病理学特征为卵巢组织中可见胚胎或绒毛,同侧输卵管正常.结论 卵巢妊娠的病因可能与盆腔炎、宫内置节育器有关,治疗以手术为主.     

妊娠合并卵巢肿瘤临床病理分析

目的探讨妊娠合并卵巢肿瘤的临床病理特征及诊断处理方案。方法对手术、病理诊断明确的78例妊娠合并卵巢肿瘤孕妇的临床病理资料进行回顾性分析。结果经手术、病理诊断明确的妊娠合并卵巢肿瘤78例,占同期妊娠者的0.09%(78/84253),良性肿瘤占96.15%(75例),以良性畸胎瘤、上皮性囊肿多见。卵巢交界性肿瘤占2.56%(2例),卵巢恶性肿瘤占1.28%(1例),并发症以卵巢肿瘤蒂扭转多见。大多行一侧附件切除术或卵巢肿瘤剔出术。结论妊娠合并卵巢肿瘤多为良性,无明显症状,应注意早期诊断,处理应根据孕周和肿瘤的性质区别对待。     

11例妊娠合并肺炎的临床分析

目的 分析妊娠合并肺炎的临床特点、诊断、治疗及母婴预后。方法 我院2003年5月至2008年4月共收治妊娠并发肺炎者15例，我们对其中11例的临床资料进行回顾性分析。结果 ①11例孕妇病人以发热为主要表现，外周血白细胞增高，肺部X线病变表现明显。②15例中4例孕早期合并肺炎，治愈，母婴结局良好；另11例妊娠合并肺炎患者（其中双胎1例）8例早产，3例足月产，新生儿窒息6例，新生儿死亡2例，孕妇均治愈出院。结论 有产科合并症的孕妇发生肺炎时容易早产，新生儿窒息增多。妊娠合并肺炎发病早期正规积极治疗，对改善母儿结局十分重要。     

妊娠合并妊娠期高血压疾病晚期妊娠258例临床分析

目的探讨妊娠期高血压疾病对晚期妊娠的影响。方法选取我院3年来孕28w以上住院分娩病例,以妊娠合并妊娠期高血压疾病258例作观察组,随机抽取正常妊娠孕妇480例作对照组,对比分析胎盘早剥、早产、胎儿窘迫、胎儿宫内发育迟缓、死产、产后出血发生率、新生儿窒息率、剖宫产率和对孕妇的影响。结果观察组的胎盘早剥、早产、胎儿窘迫、胎儿宫内发育迟缓、死胎、新生儿窒息率、产后出血发生率、剖宫产率等母婴并发症均明显高于对照组（P〈0．05）。结论妊娠期高血压疾病对晚期妊娠的母婴结局有许多不良影响。     

129例畸形子宫妊娠结局临床分析

目的 了解畸形子宫妊娠对母婴的影响.方法 对我院2001年1月至2005年12月五年间收治的129例畸形子宫妊娠进行回顾性分析.结果 资料显示其发病率为1.03%.129例畸形子宫总妊娠数356次,足月产占59.33%,其中剖宫产占51.59%.新生儿窒息及死亡共占16.96%.结论 畸形子宫分娩期并发症多,手术产率高,应尽早明确诊断,加强孕期管理及产时监护.     

妊娠合并系统性红斑狼疮13例临床分析

目的探讨妊娠合并系统性红斑狼疮（SLE）的临床特点、治疗及妊娠结局。方法回顾分析13例妊娠合并SLE患者的临床资料。结果13例孕妇除1例自行要求孕26w引产外，余12例全部顺产，胎儿成活，无畸形。结论SLE患者妊娠及分娩可使原有病情恶化，SLE对胎儿、婴儿也可产生不利影响。因此应选择在缓解期受孕，并在孕期及产后继续应用泼尼松来预防SLE恶化、控制SLE活动，争取良好妊娠结局。     

妊娠合并糖尿病34例临床分析

目的 探讨妊娠合并糖尿病对孕产妇并发症、分娩方式与围产结局、围产儿并发症的影响.方法 回顾性分析2001年1月1日至2006年9月30日34例在本院分娩的妊娠合并糖尿病（A组）与随机选择同期未发生糖尿病高危因素的正常孕产妇34例（B组）,就孕产妇并发症、分娩方式、围产结局、围产儿情况作比较分析.结果 患糖尿病组孕产妇体重指数＞30者及早产、妊娠期高血压疾病明显高于对照组,其他与对照组比较差异均无统计学意义.巨大儿、早产儿明显高于对照组,剖宫产率与对照组比较差异显著.结论 妊娠合并糖尿病对孕产妇并发症、分娩方式与围产结局有明显影响,需加强孕期管理和产时临床处理,减少母婴并发症.     

360例妊娠期高血压疾病及其并发症妊娠结局分析

目的通过对360例妊娠期高血压疾病分类比较分析,探讨新的诊断标准下妊娠期高血压疾病对母儿的影响。方法选择我院2007年1月1日～2009年8月1日在我院住院分娩的孕妇为研究对象,按新诊断标准分类分组：妊娠高血压组、轻度子痫前期组、重度子痫前期组,对比分析三组间母儿发生早产、产后出血、胎盘早剥、胎儿生长受限（FGR）、胎儿窘迫、新生儿窒息情况。结果妊娠高血压组胎儿窘迫、早产的发生率显著低于轻度组;轻度组孕产妇FGR、并发症、围产儿死亡率显著低于重度组（P〈0.01）;妊娠期高血压组产后大出血的发生率显著低于轻度组,轻度组产后出血、早产、新生儿窒息、胎儿窘迫显著低于重度组（P〈0.05）。结论妊娠期高血压疾病严重影响妊娠结局,加强孕期保健以改善母儿不良结局。     

妊娠高血压综合征性心脏病29例临床分析

目的探讨妊娠高血压综合征性心脏病的诱因及防治措施。方法对7年来我院收治的29例妊娠高血压综合征性心脏病患者的临床资料进行回顾性分析。结果29例患者均为重度妊高征,其中合并低蛋白血症19例（65.5%）、中重度贫血10例（34.5%）、肺部感染7例（24.2%）、双胎妊娠2例（6.9%）。所有孕妇均剖宫产终止妊娠,无孕产妇死亡,围生儿死亡2例（6.4%）。结论重度妊高征合并低蛋白血症、中重度贫血、肺部感染、双胎妊娠是妊高征性心脏病的重要原因。对妊高征性心脏病的诱发因素应引起重视,心衰控制后应立即终止妊娠,以减少母婴死亡。     

淀粉样变性肾病31例临床病理学分析

目的：探讨淀粉样变性肾病( amyloid nephropathy, ANP)的临床病理学特征。方法回顾性分析31例ANP的临床病理资料,并复习相关文献。结果31例ANP占同期全部肾脏穿刺活检的1．19%(31/2603),其中女性15例,男性16例。年龄36~77岁,平均(61．28±10．95)岁。临床分期：单纯蛋白尿期4例(12．90%),肾病综合征期21例(67．74%),肾功能衰竭期6例(19．35%)。镜下见淀粉样物质主要沉积于肾小球系膜区、毛细血管基膜和小动脉壁,严重时可沉积于肾小管基膜和肾间质。高锰酸钾氧化刚果红染色示：AL型27例,AA型4例。免疫荧光检测部分病例可见免疫球蛋白及补体程度较弱的沉积,部分为阴性。 AL型ANP免疫组化标记示免疫球蛋白轻链κ和λ不同程度表达,其中以λ轻链多见。电镜下在系膜区及毛细血管壁上皮下可见淀粉样纤维。结论 ANP好发于中老年肾病患者,临床表现有时缺乏特异性,肾组织穿刺活检病理学检查是确诊的唯一方法。对疑似病例应尽早行肾脏穿刺活检,以便早期诊断及治疗。     

Stem cell transplantation nephropathy: a report of six cases.

Stem cell transplantation (SCT) nephropathy is 1 cause of chronic kidney disease in patients after allogeneic SCT. It is a thrombotic microangiopathic syndrome characterized by raised creatinine, hypertension, and anemia. The difference with thrombotic thrombocytopenic purpura (TTP)-like syndromes is that it occurs later than 3 months after SCT, has marked renal dysfunction, and occurs in the absence of other complications or nephrotoxic medication. Total-body irradiation (TBI) in combination with previous chemotherapy is most likely the cause. We describe 6 cases of SCT nephropathy that occurred in a cohort of 363 patients who received myeloablative allogeneic SCT. All patients had TBI with shielding of the kidneys. We discuss the course of the syndrome, treatment, and outcome of the patients.     

Pelvic abscess in the second half of pregnancy after oocyte retrieval for in-vitro fertilization: case report.

We describe a very late manifestation of pelvic abscesses after oocyte retrieval for in-vitro fertilization (IVF). In a twin pregnancy achieved after intracytoplasmic sperm injection, rupture of bilateral ovarian abscesses occurred at the end of the second trimester. An emergency laparotomy was necessary because of an acute abdomen. This complication led to severe maternal and neonatal morbidity, preterm birth and neonatal death. The rare occurrence of acute abdomen in pregnancy due to pelvic infection and the non-specific symptoms of a pelvic abscess after oocyte retrieval for IVF are discussed.     

Dynamics of pregnancy-associated polyomavirus urinary excretion: a prospective longitudinal study

Asymptomatic polyomaviruria of pregnancy has been documented in point prevalence studies, but little attention has been given to the dynamics of polyomavirus excretion during pregnancy because of its benign course. We tested the hypothesis that the frequency and/or magnitude of polyomavirus excretion would increase as pregnancy progresses. Urine specimens were obtained prospectively from 179 healthy women during uncomplicated pregnancies and 37 healthy non‐pregnant women. Real‐time polymerase chain reaction was used to determine BK virus (BKV) and JC virus (JCV) viral loads in urine, blood, and rectal and vaginal swabs collected during routine obstetric and gynecologic clinic visits. Asymptomatic urinary shedding of BKV and/or JCV was observed in 384 (48.0%) of 800 specimens from 100 (55.8%) pregnant women. BKV excretion was more common in pregnant than non‐pregnant women (41.3% vs. 13.5%, P = 0.0026). The frequency of JCV excretion was no different in pregnant compared to non‐pregnant women. The frequency and magnitude of polyomavirus shedding did not vary with gestational age. Post‐partum shedding of BKV, but not JCV, rapidly decreased to undetectable levels. Pregnancy‐associated BKV excretion begins early in pregnancy and terminates rapidly post‐partum. Neither the frequency nor magnitude of BKV or JCV shedding increased with pregnancy progression. Further study into the host factors that regulate pregnancy‐associated BKV excretion may allow identification of the host factors that predict susceptibility to BKV‐associated diseases in immune compromised patients. J. Med. Virol. 84: 1312–1322, 2012. © 2012 Wiley Periodicals, Inc.     

Unsuspected pregnancy at hysterosalpingography: a report of three cases with different outcomes

We report three cases of unsuspected pregnancy during hysterosalpingography (HSG) with different outcomes. In the first two cases, menstrual history was wrongly relied upon and no pregnancy tests had been performed. However, even with a negative pregnancy test carried out prior to the investigation, as in the third case, this was proven not to be foolproof. The outcome of our pregnancies involves one ectopic, one miscarriage and one normal term pregnancy. We advocate not relying solely on menstrual history and to be aware that even in cases where there is a negative pregnancy test before HSG, the patient can still be pregnant. Although the reporting of unsuspected pregnancy during HSG is rare, there is still a need to be alert, especially in high-risk patients with irregular, long menstrual cycles and unprotected intercourse prior to the investigation.     

前列腺平滑肌肉瘤9例临床病理分析

目的探讨前列腺平滑肌肉瘤的病理学诊断、组织形态学特征、鉴别诊断及发病率情况。方法收集解放军总医院1990年~2008年19年间共诊出的平滑肌肉瘤9例,做常规HE染色及免疫组化染色,并复习文献。结果前列腺平滑肌肉瘤占同期前列腺恶性肿瘤的1%。患者发病年龄27~56岁,平均43岁。免疫组化染色具有特征,即actin为指标性抗体、其次为calponin,同时muscle、desmin、vimentin亦示阳性反应。结论前列腺平滑肌肉瘤发病率很低,临床上主要以进行性排尿困难。影像学检查有助于发现前列腺占位性病变,确诊要靠前列腺穿刺活检组织学诊断。     

Intraabdominal myositis ossificans: a report of 9 new cases

Intraabdominal myositis ossificans (IMO) is a rare benign disorder characterized by reactive bone formation in intraabdominal soft tissue that should be distinguished from a malignant condition. We retrospectively searched our patient records and report 9 new cases of IMO. The lesions occurred in 7 men and 2 women with a mean age of 50 years (range, 24--76 years), 5 of whom had previous abdominal surgery. Histologically, all the cases were similar, consisting of a reactive mesenchymal process in adipose tissue. Mitosis was observed, but with no atypical forms, and the lesions lacked malignant cytologic features. IMO is an uncommon benign lesion that develops relatively rapidly. The pathogenesis is related to intraabdominal surgical procedures, but the exact mechanism remains to be determined.     

Left ectopic pregnancy following gamete intra-fallopian transfer into the right fallopian tube: a report on two cases

Two cases are reported in which GIFT was performed into the right Fallopian tube, both resulting in ectopic pregnancy in the left Fallopian tube. The possible aetiological factors for the occurrence of contralateral ectopic pregnancy are discussed.     

The occurrence and outcome of 39 pregnancies after 1621 cases of transcervical resection of endometrium

BACKGROUND: To evaluate the outcomes and management of pregnancy after transcervical resection of the endometrium (TCRE). METHODS: Retrospective study of 39 pregnancies after 1621 procedures of TCRE. RESULTS: Among 1621 women who were successfully followed up after TCRE, there were 39 pregnancies in 32 women, including five ectopic pregnancies (12.8%) and 34 intrauterine pregnancies (87.2%). The majority of pregnancies (84.6%) occurred within the first 2 years. In the first year after TCRE, the incidence of pregnancy was 1.5%. In women who had amenorrhoea after TCRE, the chances of conception (2/676; 0.3%) were significantly (P < 0.001) lower than for those who continued to have period (30/945; 3.2%). Thirty-two cases with intrauterine pregnancy were terminated under ultrasound guidance with two difficult procedures. Only one pregnancy in our study resulted in spontaneous miscarriage which was managed by suction curettage. One term pregnancy had placenta increta resulting in Caesarean hysterectomy. CONCLUSIONS: Pregnancies after TCRE are associated with increased risk, and clinicians should be aware of the various complications of pregnancy that may occur after TCRE, including an increased risk of ectopic pregnancy. Surgical termination of pregnancy after TCRE is potentially a difficult procedure and should be carried out under ultrasound guidance.     

后肾性腺瘤3例报道并文献复习

目的：探讨后肾性腺瘤的病理形态学特征及诊断要点。方法：采用常规HE染色及免疫组化染色，并复习文献。结果：组织学上主要由紧密而规则排列 的圆形小管和含有圆形细胞巢的实性区相间排列，偶见肾小球样结构。免疫组化以Leu7、vimetntin、keratin阳性及EMA阴性为特点。结论：后肾性腺瘤是肾胚胎残留发生的罕见良性肿瘤，常被误诊为恶性肿瘤，故与肾母细胞瘤、乳头状肾细胞癌鉴别尤为重要。